Trends of Stroke Incidence from 1995 to 2013 in Joinville, Brazil

2016 ◽  
Vol 46 (4) ◽  
pp. 273-281 ◽  
Author(s):  
Norberto L. Cabral ◽  
Pedro T. Cougo-Pinto ◽  
Pedro S.C. Magalhaes ◽  
Alexandre L. Longo ◽  
Carla H.C. Moro ◽  
...  
Keyword(s):  
Low Income ◽  
Temporal Trends ◽  
Epidemiological Data ◽  
Haemorrhagic Stroke ◽  
Data Bank ◽  
Low Income Countries ◽  
Stroke Incidence ◽  
Stroke Registry ◽  
Quit Smoking ◽  
Adjusted Incidence

Background: Temporal trends on the incidence of stroke and its subtypes could help assess on-going public health policies and point to further targets for action among middle- and low-income countries, where the stroke burden is very high. This study aimed at evaluating longitudinal trends of stroke incidence in Joinville, Brazil. Methods: We ascertained the incidence of all first-ever strokes occurred in 1995, 2005-2006 and 2012-2013, which were extracted from Joinville Stroke Registry, a prospective epidemiological data bank, launched in 1995. Results: From 1995 to 2013, the age-adjusted incidence of all strokes decreased 37% (95% CI 32-42). From 2005 to 2013, the haemorrhagic stroke (HS) incidence decreased 60% (95% CI 13-86), ischemic stroke (IS) incidence decreased 15% (95% CI 1-28), and subarachnoid haemorrhage incidence remained stable. The proportion of IS and HS patients with regularly treated hypertension increased by 60% (p = 0.01) and 33% (p = 0.01), respectively. The proportion of IS and HS patients that quit smoking increased 8% (p = 0.03) and 17% (p = 0.03), respectively. Conclusions: Stroke incidence has been decreasing in Joinville over the last 18 years, more so for HS than IS. Better control of hypertension and tobacco use might explain these findings.

Temporal Trends in Generic and Brand Prices of Antiretroviral Medicines Procured with Donor Funds in Developing Countries

2010 ◽  
Vol 7 (2) ◽  
pp. 159-175 ◽  
Author(s):  
Brenda Waning ◽  
Warren Kaplan ◽  
Matthew P Fox ◽  
Mariah Boyd-Boffa ◽  
Alexis C King ◽  
...  
Keyword(s):  
Low Income ◽  
Price Competition ◽  
Public Procurement ◽  
Universal Access ◽  
Temporal Trends ◽  
World Health ◽  
Low Income Countries ◽  
Careful Examination ◽  
Price Variation ◽  
Middle Income

Pharmaceutical markets in low resource settings are imperfect. Suppliers provide information on ‘suggested’ medicine prices, but actual purchase prices vary substantially across purchasers and these prices paid are typically unavailable. Public procurement databases now, however, provide timely market intelligence on prices for antiretroviral (ARV) medicines purchased with donor funds, allowing for careful examination of market trends. We used data posted by the World Health Organization to create a longitudinal database of 15 111 ARV procurements from 2002–2008. We noted dramatic price reductions for ARVs over this 6-year time period. Most generic ARVs were cheaper than branded counterparts, with the exception of protease inhibitors (PIs) in which some generic versions were more expensive than branded counterparts. Less price variation was noted for ARVs in low-income countries than middle-income countries where price variations of threefold or greater were noted in five of 28 (18 per cent) generic and 15 of 25 (60 per cent) brand dosage forms. In order to meet global goals of universal access to HIV/AIDS treatment, further price reductions are needed for abacavir, tenofovir and PIs. New approaches are needed to create incentives for generic manufacturers of these ARVs to enter the market and create price competition with these medicines.

Temporal Trends in the Incidence of Ischemic Stroke in Young Adults: Dijon Stroke Registry

2021 ◽  
pp. 1-6
Author(s):  
Yannick Béjot ◽  
Gauthier Duloquin ◽  
Quentin Thomas ◽  
Sophie Mohr ◽  
Lucie Garnier ◽  
...  
Keyword(s):  
Young Adults ◽  
Sex Differences ◽  
Ischemic Stroke ◽  
Temporal Trends ◽  
Population Based ◽  
Incidence Rates ◽  
Stroke Incidence ◽  
Stroke Registry ◽  
Stroke In Young Adults ◽  
Stroke In Young

<b><i>Introduction:</i></b> Stroke is associated with major consequences in terms of socioeconomic impact and lost disability-adjusted life in young victims, thus justifying a careful surveillance of epidemiological trends. This study aimed to assess changes in the incidence of ischemic stroke in young adults over a long period. <b><i>Methods:</i></b> All cases of first-ever ischemic stroke that occurred among adults aged 18–55 years were prospectively recorded using the population-based Dijon Stroke Registry, from 1985 to 2017. Sex-specific annual incidence rates were calculated and were presented according to 6 time periods. Incidence rate ratios (IRRs) were determined to assess sex differences in stroke incidence. <b><i>Results:</i></b> Over the whole study period, 4,451 patients suffered a first-ever ischemic stroke. Among these patients, 469 (10.5%) were young adults (median age: 46 years, IQR: 39–50; 53.9% men). Incidence rates rose from the study period 2003 to 2007 compared with previous periods and remained stable thereafter, both in men and women. Hence, incidence per 100,000 per year was globally 11.0 (95% CI: 9.4–12.7) before 2003 and 22.9 (20.3–25.6) thereafter. In individuals aged 18–45 years, incidence rates were 5.4 (4.3–6.9) overall, 4.1 (2.7–6.0) in men, and 6.7 (4.9–9.0) in women, before 2003. After 2003, incidence rates rose to 12.8 (10.7–15.1) overall, 12.0 (9.2–15.4) in men, and 13.6 (10.6–17.0) in women. In this age group, the men/women IRR was 0.78 (95% CI: 0.62–1.26, <i>p</i> = 0.08), although sex differences decreased over time (IRR = 0.62; 95% CI: 0.36–1.02, <i>p</i> = 0.046 before 2003, vs. IRR = 0.88; 95% CI: 0.62–1.26, <i>p</i> = 0.48 after 2003). In individuals aged 45–55 years, incidence rates before 2003 were 47 (37–61) in men and 25 (17–35) in women (IRR = 1.90; 95% CI: 1.24–2.97, <i>p</i> &#x3c; 0.001), and they increased to 82 (67–100) in men and 46 (35–59) in women (IRR = 1.79; 95% CI: 1.29–2.49, <i>p</i> &#x3c; 0.001) after 2003. <b><i>Conclusions:</i></b> The incidence of ischemic stroke in young adults increased during the early 2000s and remained stable thereafter. These results highlight the priority need for dedicated prevention strategies for the young to reduce the burden of stroke.

scholarly journals Prevalence of Human Immunodeficiency Virus and Malaria Co-Infection in Nigeria: A Review of Published Literature

2019 ◽  
Vol 12 (1) ◽  
pp. 30
Author(s):  
Omotayo S. Alaofin ◽  
Kantharuben Naidoo
Keyword(s):  
Human Immunodeficiency Virus ◽  
Literature Review ◽  
Low Income ◽  
Highly Active Antiretroviral Therapy ◽  
Management Practice ◽  
Epidemiological Data ◽  
Google Scholar ◽  
Low Income Countries ◽  
Infection Prevalence ◽  
Immunodeficiency Virus

Background: Human immunodeficiency virus and malaria are significant global health challenges. Both diseases contribute to the global burden of disease and poverty notable amongst low-income countries, including sub-Sahara Africa and Nigeria. There are little or no available review articles on the prevailing epidemiological data on human immunodeficiency virus and malaria interaction in Nigeria. Aim: This literature review aims to update knowledge on human immunodeficiency virus and malaria co-infection and determine the prevalence of human immunodeficiency virus and malaria from published literature. Method: This work reviewed published articles on human immunodeficiency virus/malaria co-infection published in English in PubMed, Google Scholar, and ScienceDirect. An internet search on Google Scholar was also conducted for studies that were conducted between 2007 and 2017 in Nigeria. Result: The literature review indicated that the highest prevalence of human immunodeficiency virus and malaria co-infection in Nigeria is 86.2%. The mean &plusmn; SD among the HIV-malaria co-infected group and the negative malaria group in all of Nigeria&rsquo;s geo-political zones are 36.6 &plusmn; 25.5 and 19.5 &plusmn; 15.3, respectively. The highest mean prevalence of 64.5% was reported in human immunodeficiency virus patients co-infected with malaria in the northwest zone. The use of highly active antiretroviral therapy is also associated with a reduced mean positive prevalence of 31.26%. Conclusion: Human immunodeficiency virus-positive individuals across all the geopolitical zones in Nigeria are at high risk of malaria. Findings from this review of literature will provide additional information on HIV-malaria co-infection prevalence and guide public health prevention, control and management practice.

Three Cases of Joubert Syndrome in a Consanguineous Syrian Family and a Interesting Case of Multinational Collaboration

2021 ◽  
Author(s):  
Davor Petrović ◽  
Vida Čulić ◽  
Zofia Swinderek-Alsayed
Keyword(s):  
Low Income ◽  
Autosomal Recessive ◽  
Autosomal Recessive Disorder ◽  
Joubert Syndrome ◽  
Interesting Case ◽  
Low Income Countries ◽  
Ocular Motor ◽  
Quality Health Care ◽  
Quality Health ◽  
Motor Apraxia

AbstractJoubert syndrome (JS) is a rare congenital, autosomal recessive disorder characterized by a distinctive brain malformation, developmental delay, ocular motor apraxia, breathing abnormalities, and high clinical and genetic heterogeneity. We are reporting three siblings with JS from consanguineous parents in Syria. Two of them had the same homozygous c.2172delA (p.Trp725Glyfs*) AHI1 mutation and the third was diagnosed prenatally with magnetic resonance imaging. This pathogenic variant is very rare and described in only a few cases in the literature. Multinational collaboration could be of benefit for the patients from undeveloped, low-income countries that have a low-quality health care system, especially for the diagnosis of rare diseases.

Reviewing the Development of Rural Finance in Vietnam

2013 ◽  
pp. 121-136
Author(s):  
Duong Pham Bao
Keyword(s):  
Low Income ◽  
Financial System ◽  
Low Income Countries ◽  
Supply Side ◽  
New Paradigm ◽  
Rural Finance ◽  
Market Mechanisms ◽  
Rural Credit ◽  
Rural Organizations ◽  
Doi Moi

The objective of this article is to review the development of the rural financial system in Vietnam in recent years, especially, after Doi moi. There are two opposite schools of thought in the literature on rural credit policies in developing countries. One is the conventional supply-side (government-led) approach while the other is called “a new paradigm” that emphasizes the importance of the viability of financial providers and the well functioning of rural credit markets. Conventional theories of rural finance contend that rural finance in low-income countries is generally accompanied by many failures. Contrary to these theories, rural finance in Vietnam does not encounter the above-mentioned failures so far. Up to the present time, it is progressing well. Using a supply-side approach, methodologically, this study reviews the development of the rural financial system in Vietnam. The significance of this study is to challenge the extreme view of dichotomizing between the old and the new credit paradigms. Analysis in this study contends that a rural financial market that, (1) is initiated and spurred by government; (2) operates principally under market mechanisms; and (3) is strongly supported by rural organizations (semi-formal/informal institutions) can progress stably and well. Therefore, the extremely dichotomizing approach must be avoided.

Abdominal Textiloma Mimicking as Left Colic Tumour: A Postoperative Complication Still Common in Low-Income Countries

EMJ Radiology ◽  
2020 ◽  
Keyword(s):  
Low Income ◽  
Early Stage ◽  
Low Income Countries ◽  
Fistula Formation ◽  
Emergency Laparotomy ◽  
Intermittent Fever ◽  
Gastrointestinal Complications ◽  
Surgical Safety ◽  
Surgical Teams ◽  
Safety Rules

Retained foreign bodies have become very rare in countries where the safety rules in the operating theatre are very rigorous and follow precise guidelines. There are low-income countries where hospital structures are precarious, in which the implementation of surgical safety rules has only been effective recently. Surgical teams in these countries are not yet well trained in the observance of the guidelines concerning swab count, meaning that textilomas are not uncommon. Abdominal textiloma may be asymptomatic, or present serious gastrointestinal complications such as bowel obstruction, perforation, or fistula formation because of misdiagnosis. It may mimic abscess formation in the early stage or soft tissue masses in the chronic stage. This case report presents a 27-year-old female who underwent an emergency laparotomy in a rural surgical centre for an ectopic pregnancy. Two months later, a swelling had appeared on the left side of her abdomen, gradually increasing in size, which was not very painful but caused digestive discomfort and asthenia. Intermittent fever was described and treated with antibiotics. The patient was referred to a better equipped centre to benefit from a CT scan. A textiloma was strongly suspected on the CT but a left colic mass was not excluded. Laparotomy confirmed the diagnosis of textiloma and the postoperative course was uneventful. Prevention rules must be strengthened in these countries where patients can hardly bear the costs of iterative surgeries for complications that are avoidable.

Assessment of knowledge and practice of vaccination of dogs against rabies by dog owners in Makurdi, Benue State, Nigeria

2020 ◽  
Vol 1 ◽  
pp. 5
Author(s):  
Audu Onyemocho ◽  
Agwa Moses ◽  
Aboh Kisani ◽  
Omole Namben Victoria ◽  
Anejo-Okopi Joseph
Keyword(s):  
Low Income ◽  
Life Time ◽  
Knowledge Score ◽  
Educational Status ◽  
Low Income Countries ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
Knowledge And Practice ◽  
Dog Owners ◽  
The Relationship

Objective: Rabies, one of the oldest and fatal infectious diseases known to human race, is transmitted by infected dogs. The global target of zero dog-mediated rabies human deaths has been set for 2030; however, the realization of this goal poses challenges in most low-income countries where rabies is endemic due to weak surveillance. Dogs have been increasingly deployed for domestic uses over the years, especially for security purposes. This study assessed the assessment of knowledge and practice of vaccination of dogs against rabies by dog owners. Materials and Methods: A cross-sectional community-based study was employed to study 400 dog owners in Makurdi metropolis through multistage sampling techniques. Sighting of valid dog vaccination card was used as criteria for current vaccination. Bivariate analysis was carried out to establish the relationship between the respondent knowledge of rabies and dog vaccination with significant value set at P < 0.05. Results: The mean age of the respondents was 31 (Â ± 0.8) years, majority of them had tertiary and secondary education (40.0% and 39.0%, respectively), 26.0% were traders, and 50.0% were married. Overall, 73.0% of the respondents had good knowledge score, 61.0% had seen at least a rabid dog in their life time, and 74.0% have a history of dog vaccination, but evidence of up to date vaccination of dogs by owners was seen in only 18.0% of all the vaccination cards sighted. The relationship between the educational status of the respondents, their knowledge score, and their dog vaccination was statistically significant (P < 0.05). Conclusion: Knowledge of rabies among dog owners in Makurdi was good, but the practice of dog vaccination was poor. Educational status was a good predictor of practice. Awareness campaign on dog vaccination should be strengthened and adequate measures should be put in place at the veterinary hospitals in Makurdi for vaccination of dogs.

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